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General NPI Number Information
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NPI Number | 1578760567
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Entity Type | Organization
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Legal Business Name | CRUM DOGGWILER AND STEFANKO LTD
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4791 SUMMIT RIDGE DR
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City | RENO
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State | NV
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Zip | 89523
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Country | US
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Telephone | 775-624-2200
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Fax | 775-624-2211
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Provider Business Mailing Address
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Address Line | 4791 SUMMIT RIDGE DR
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City | RENO
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State | NV
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Zip | 89523
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Country | US
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Telephone | 775-624-2200
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Fax | 775-624-2211
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DONALD CRUM
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Credential | M.D.
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Telephone | 775-624-2200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 5663
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License Number State | NV
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